PRIVACY POLICY

PARK PHARMACY GROUP
HUHN PHARMACY, NORTH CENTRAL IV, PARK PHARMACY, & WHITE CROSS PHARMACY

NOTICE OF PRIVACY PRACTICES

This notice describes how medical information about you may be used and disclosed & how you can get access to this information. Please review it carefully.

The Pharmacy is required by law to maintain the privacy of Protected Health Information (“PHI”) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to PHI about you.

The Pharmacy is required to follow the terms of this Notice. We will not use or disclose PHI about you without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you.

I. Uses and Disclosures of Protected Health Information (PHI)
For treatment purposes, use and disclosure of PHI will take place in providing, coordinating, or managing healthcare and its related services by one or more of your providers, such as when your pharmacist consults with your physician or a specialist regarding your medications, treatment, or condition.

For payment purposes, use and disclosure of PHI will take place to obtain or provide reimbursement for providing pharmaceutical care services, such as when your case is reviewed to ensure appropriate care was rendered. For reimbursement purposes, your PHI may be disclosed to one or several intermediaries employed by your plan sponsor including but not limited to insurers, pharmacy benefits managers, claims administrators, and computer switching companies.

For healthcare operation purposes, use and disclosure of PHI will take place in a number of ways, including for quality assessment and improvement, provider review and training, underwriting activities, review and compliance activities; planning, development, management and administration. Your information could be used, for example, to assist in the evaluation of the quality of care you were provided.

In addition, we may contact you to provide refill reminders, health screenings, wellness events, inoculations, vaccinations or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

We may use and disclose your PHI, without your authorization, when the pharmacy needs to contact a health care provider or staff member and is permitted or required to do so without individual written consent or authorization. We may use and disclose your PHI if we are contacted by another pharmacy that states they have your request and consent to transfer pharmacy records to them.

We may disclose PHI about you without your authorization to comply with workers compensation laws, as required by law enforcement, legal proceedings, public health requirements, health oversight activities, and as required by law.

From time to time, we may employ the services of business associates who may assist us in one or more tasks and who may use, change, or create PHI. Business associates are required to comply with all the privacy regulations on your behalf.
Other uses and disclosures will be made only with your written authorization, and you may revoke your authorization at any time by notifying us as described in Section III of this notice, except to the extent the Pharmacy has already taken action in reliance on a previously signed authorization form.
You may ask us to restrict uses and disclosures of your PHI to carry out treatment, payment, or healthcare operations. However, we are not required to agree to your request.

II. Your Health Information Rights

You have the right to request the following with respect to your PHI: (i) inspection and copying; (ii) amendment or correction; (iii) an accounting of the disclosures of this information by us; (We are not required to account to you for disclosures made for treatment, payment, operations, disclosures to you, coordination of treatment and communications or as otherwise excluded by law); and (iv) receipt of a paper copy of this notice upon request. The Pharmacy will require patients to make requests for access to their PHI in writing.

In addition, you may request, and we must accommodate the request, if reasonable, to receive communications of PHI by alternative means or at alternative locations. To make this request please contact us as described in Section III.

The Pharmacy may charge for copying, supplies, labor, and the postage involved in preparing PHI for your request. If you desire a price quote for this service, you must request one. You have the right to withdraw your request of the PHI prior to the delivery.

We may use your name to reference your prescriptions and pharmaceutical care services. You may be required to provide a written signature to acknowledge receipt of service, to acknowledge receipt of this notice and the disclosure of PHI. You may restrict or prohibit uses and disclosures of PHI by notifying the Privacy Officer of the Pharmacy in writing of your restriction or prohibition. We are not required to honor those requests. If you request our services, we are able to provide treatment services to you, even if you object to signing the acknowledgement of the receipt of this notice or if we decide not to honor a request regarding the information in this document while noting your requests and refusals in our records. In the event of an emergency or your incapacity, we will do in our reasonable judgment what is consistent with your known preference, and what we determine to be in your best interest. We will inform you of any such uses or disclosures under such circumstances and give you an opportunity to object as soon as practicable.

We will also use our judgment and experience regarding your best interest in allowing people to pick-up prescriptions. If you are incapacitated, there is an emergency, or you object to this use or disclosure, we will do what, in our judgment, is in your best interest regarding such disclosure and will disclose only the information that is directly relevant to the person’s involvement with your healthcare.

III. Contacting Us
The Park Pharmacy Group has an appointed Privacy Officer. You may contact the Privacy Officer at the location you receive pharmacy services if you have questions (this is also the location where your PHI is maintained) or would like additional information about the pharmacy’s privacy practices. If you believe your privacy rights have been violated, you can file a complaint with thePrivacy Officer at the pharmacy where you receive services or with the Secretary of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Ave SW, Washington, DC 20201. There will be no retaliation for filing a complaint.

Privacy Officer       
Huhn Pharmacy         
522 Main St West      
Ashland, WI 54806     
715-682-3123          

Privacy Officer                 
North Central IV                     
138 ½ N 2nd Ave                     
Park Falls, WI 54552                 
715-762-3248                       

Privacy Officer    
Park Pharmacy             
138 N 2nd Ave             
Park Falls, WI 54552         
715-762-3374             

Privacy Officer
White Cross Pharmacy
314 Silver Street
Hurley, WI 54534
715-561-5666

This Notice is effective August 1, 2010.